Yu Xi, Zhongsheng Li, Surendran Vatatheeswaran, Valter Devecchi, Alessio Gallina
{"title":"Assessment of Pelvic Motion During Single-Leg Weight-Bearing Tasks Using Smartphone Sensors: Validity Study.","authors":"Yu Xi, Zhongsheng Li, Surendran Vatatheeswaran, Valter Devecchi, Alessio Gallina","doi":"10.2196/65342","DOIUrl":"https://doi.org/10.2196/65342","url":null,"abstract":"<p><strong>Background: </strong>Clinicians and athletic training specialists often assess the performance of single-leg, weight-bearing tasks to monitor rehabilitation progress and guide exercise progression. Some of the key metrics assessed are excessive pelvic motion, balance, and duration of each repetition of the exercise. Motion can be objectively characterized using motion capture (MOCAP); however, MOCAP is often not available in clinics due to the high costs and complexity of the analyses. Smartphones have built-in sensors that can be used to measure changes in body segment orientation and acceleration, which may make them a more feasible and affordable technology to use in practice.</p><p><strong>Objective: </strong>This study aimed to determine if, compared to gold-standard MOCAP, smartphone sensors can provide valid measures of pelvic orientation, acceleration, and repetition duration during single-leg tasks in healthy individuals.</p><p><strong>Methods: </strong>Overall, 52 healthy participants performed single-leg squats and step-down tasks from heights of 15 and 20 cm. Pelvic motion was assessed using MOCAP and a smartphone placed over the sacrum. The MATLAB (MathWorks) mobile app was used to collect smartphone acceleration and orientation data. Individual repetitions of each exercise were manually identified, and the following outcomes were extracted: duration of the repetition, mediolateral acceleration, and 3D pelvic orientation at peak squat. Validity was assessed by comparing metrics assessed with a smartphone and MOCAP using intraclass correlation coefficients (ICCs) and paired Wilcoxon tests. Differences between tasks were compared using 1-way ANOVA or the Friedman test.</p><p><strong>Results: </strong>Across the 3 single-leg tasks, smartphone estimates demonstrated consistently high agreement with the MOCAP for all metrics (ICC point estimates: >0.8 for mediolateral acceleration and frontal plane orientation; >0.9 for squat duration and orientation on the sagittal and transverse plane). Bias was identified for most outcomes (multiple P<.001). Both smartphone and MOCAP recordings identified clear differences between tasks, with step-down tasks usually requiring larger changes in pelvic orientation and larger mediolateral sways. Duration did not differ between tasks.</p><p><strong>Conclusions: </strong>Despite a consistent bias, the smartphone demonstrated good to excellent validity relative to gold-standard MOCAP for most outcomes. This demonstrates that smartphones offer an accessible and affordable tool to objectively characterize pelvic motion during different single-leg weight-bearing tasks in healthy participants. Together with earlier reports of good between-day reliability of similar measures during single-leg squats, our results suggest that smartphone sensors can be used to assess and monitor single-leg task performance. Future studies should investigate whether smartphone sensors can aid in the assessment and treatme","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e65342"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lisa Sheehy, Anne Taillon-Hobson, Heidi Sveistrup, Martin Bilodeau, Christine Yang, Vivian Welch, Hillel Finestone
{"title":"Home-Based Nonimmersive Virtual Reality Training After Discharge From Inpatient or Outpatient Stroke Rehabilitation: Parallel Feasibility Randomized Controlled Trial.","authors":"Lisa Sheehy, Anne Taillon-Hobson, Heidi Sveistrup, Martin Bilodeau, Christine Yang, Vivian Welch, Hillel Finestone","doi":"10.2196/64729","DOIUrl":"https://doi.org/10.2196/64729","url":null,"abstract":"<p><strong>Background: </strong>Nonimmersive virtual reality training (NIVRT) can be used to continue rehabilitative exercise for stroke recovery at home after discharge from inpatient or outpatient therapy.</p><p><strong>Objective: </strong>The objectives of this randomized controlled feasibility trial were to assess home-based NIVRT as telerehabilitation with patients living with stroke, and its potential to improve standing function and gait.</p><p><strong>Methods: </strong>Patients approaching discharge from inpatient or outpatient stroke rehabilitation were randomly allocated to NIVRT or iPad interventions. NIVRT provided interactive games and exercises designed to improve balance, stepping, and aerobic capacity. iPad apps addressed cognition and fine motor skills. Participants were visited in their homes by a physiotherapist, taught to use the program, and asked to do 30 minutes of exercise 5 days a week for 6 weeks, asynchronously. Feasibility was assessed by measuring recruitment, adherence, ability to set up and learn NIVRT, enjoyment, intent to continue, perception of impact, and safety. Participants completed assessments of standing balance, gait, and general function, before and after the intervention, by a blinded assessor.</p><p><strong>Results: </strong>NIVRT participants (n=11; 10 male participants; mean age 64, SD 12 years) did an average of 26 sessions (total 700 minutes), while iPad participants (n=9; 6 male participants; mean age 61, SD 20 years) did an average of 33 sessions (total 1241 minutes). Space was tight in 5 homes. All but 1 participant learned NIVRT and progressed. Most enjoyed it and felt that it improved their recovery. There were no serious adverse events. Most assessments showed improvement over time for both groups.</p><p><strong>Conclusions: </strong>Home-based NIVRT is safe and feasible to continue rehabilitative exercise after discharge. More research on efficacy and effectiveness in this population is required.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT03261713; https://clinicaltrials.gov/study/NCT03261713.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.1186/s13063-019-3438-9.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e64729"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effects of a Home-Based Rehabilitation Exercise Program on Cardiorespiratory Performance in Community-Dwelling Adults Who Underwent Heart Surgery: Randomized Controlled Trial.","authors":"Natsinee Sermsinsaithong, Kornanong Yuenyongchaiwat, Chusak Thanawattano, Chatchai Buekban, Chitima Kulchanarat, Sasipa Buranapuntalug, Khanistha Wattanananont, Opas Satdhabudha","doi":"10.2196/68504","DOIUrl":"https://doi.org/10.2196/68504","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing heart surgery demonstrate impaired cardiorespiratory performance. Phase II cardiac rehabilitation (CR) in people undergoing open heart surgery (OHS) aims to reduce the adverse physical effects of cardiovascular diseases. Virtual reality (VR) exercise is now used in CR.</p><p><strong>Objective: </strong>This study aimed to explore the effects of VR exercise on functional capacity, pulmonary function, and respiratory muscle strength in patients who underwent OHS and were in phase II CR.</p><p><strong>Methods: </strong>Forty-nine patients who underwent elective OHS and were in phase II CR were randomized into a VR group (N=24) and a control group (N=25). The VR group completed 8 weeks of a home-based VR exercise program, including chest trunk mobilization and aerobic circuit training for 30 minutes, whereas the control group received an exercise brochure and information regarding the benefits of exercise. Intention-to-treat analysis was conducted, and 2-way mixed ANOVA was performed to compare between- and within-group differences in functional capacity and respiratory performance.</p><p><strong>Results: </strong>After completing the 8-week program, the VR group showed significant improvement in functional capacity compared to the control group (66.29, SD 25.84 m; P=.01). Inspiratory muscle strength increased in both the VR and control groups compared to baseline (9.46, SD 2.85 and 9.64, SD 2.78 cm H2O, respectively). In addition, after the 8-week intervention, significant improvements were found in expiratory muscle strength (15.79, SD 4.65 cm H2O) and forced expiratory volume in 1 second as a percentage of predicted values (2.96%, SD 1.52%) in the VR group compared to the baseline session.</p><p><strong>Conclusions: </strong>The home-based VR exercise program significantly improved functional capacity but not respiratory muscle or pulmonary function.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e68504"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giulio E Lancioni, Gloria Alberti, Chiara Filippini, Nirbhay N Singh, Mark F O'Reilly, Jeff Sigafoos, Valeria Chiariello, Oriana Troccoli
{"title":"A Technology System to Help People With Multiple Disabilities Increase Contact With Objects and Control Environmental Stimulation: Single-Case Research Design.","authors":"Giulio E Lancioni, Gloria Alberti, Chiara Filippini, Nirbhay N Singh, Mark F O'Reilly, Jeff Sigafoos, Valeria Chiariello, Oriana Troccoli","doi":"10.2196/70378","DOIUrl":"https://doi.org/10.2196/70378","url":null,"abstract":"<p><strong>Background: </strong>People with severe-to-profound intellectual disability and sensory-motor impairment tend to be passive and detached from their immediate context.</p><p><strong>Objective: </strong>This study assessed a new technology system using a webcam to detect participants' responses (ie, hand contact with objects) and to trigger computer delivery of preferred environmental stimulation, such as music, contingent on (immediately after) the occurrence of those responses.</p><p><strong>Methods: </strong>In total, 8 adults with severe to profound intellectual disability and extensive motor and visual impairments participated in the study. Each participant was exposed to an ABACB design. The technology system did not provide stimulation during the A (baseline) phases, provided stimulation contingent on the responses during the B (intervention) phases, and provided stimulation throughout the sessions during the C (control) phase. Sessions lasted 5 minutes.</p><p><strong>Results: </strong>During the first baseline phase, the participants' mean frequency of responses per session was between about 3 and 6.5. During the first intervention phase, it increased to between about 10 and 18. It showed a clear decline during the second baseline phase, remained low during the control phase, and increased again during the second intervention phase. During this phase, it ranged from about 13 to 19.5.</p><p><strong>Conclusions: </strong>The new technology system might be a useful tool to help people with intellectual and sensory-motor disabilities increase object contact and stimulation control.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e70378"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mahdie Rafiei, Supratim Das, Mohammad Bakhtiari, Ewa Maria Roos, Søren T Skou, Dorte T Grønne, Jan Baumbach, Linda Baumbach
{"title":"Personalized Predictions for Changes in Knee Pain Among Patients With Osteoarthritis Participating in Supervised Exercise and Education: Prognostic Model Study.","authors":"Mahdie Rafiei, Supratim Das, Mohammad Bakhtiari, Ewa Maria Roos, Søren T Skou, Dorte T Grønne, Jan Baumbach, Linda Baumbach","doi":"10.2196/60162","DOIUrl":"10.2196/60162","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (OA) is a common chronic condition that impairs mobility and diminishes quality of life. Despite the proven benefits of exercise therapy and patient education in managing OA pain and functional limitations, these strategies are often underused. To motivate and enhance patient engagement, personalized outcome prediction models can be used. However, the accuracy of existing models in predicting changes in knee pain outcomes remains insufficiently examined.</p><p><strong>Objective: </strong>This study aims to validate existing models and introduce a concise personalized model predicting changes in knee pain from before to after participating in a supervised patient education and exercise therapy program (GLA:D) among patients with knee OA.</p><p><strong>Methods: </strong>Our prediction models leverage self-reported patient information and functional measures. To refine the number of variables, we evaluated the variable importance and applied clinical reasoning. We trained random forest regression models and compared the rate of true predictions of our models with those using average values. In supplementary analyses, we additionally considered recently added variables to the GLA:D registry.</p><p><strong>Results: </strong>We evaluated the performance of a full, continuous, and concise model including all 34 variables, all 11 continuous variables, and the 6 most predictive variables, respectively. All three models performed similarly and were comparable to the existing model, with R2 values of 0.31-0.32 and root-mean-squared errors of 18.65-18.85-despite our increased sample size. Allowing a deviation of 15 (visual analog scale) points from the true change in pain, our concise model correctly estimated the change in pain in 58% of cases, while using average values that resulted in 51% accuracy. Our supplementary analysis led to similar outcomes.</p><p><strong>Conclusions: </strong>Our concise personalized prediction model provides more often accurate predictions for changes in knee pain after the GLA:D program than using average pain improvement values. Neither the increase in sample size nor the inclusion of additional variables improved previous models. Based on current knowledge and available data, no better predictions are possible. Guidance is needed on when a model's performance is good enough for clinical practice use.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e60162"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development of a Mobile App Game for Practicing Lung Exercises: Feasibility Study.","authors":"Chatkhane Pearkao, Korakot Apiratwarakul, Lerkiat Wicharit, Wiphawadee Potisopha, Arunnee Jaitieng, Sukuman Homvisetvongsa, Puthachad Namwaing, Peerapon Pudtuan","doi":"10.2196/63512","DOIUrl":"10.2196/63512","url":null,"abstract":"<p><strong>Background: </strong>Chest injuries are a leading cause of death and disability, accounting for 10% of hospital admissions and 25% of injury-related deaths. About two-thirds of patients with thoracic injuries experience complications such as blood or air in the pleural space, causing lung deflation and poor gas exchange. Proper breathing management, using tools like incentive spirometers, improves lung function and recovery. However, there is a gap in mobile-based gaming apps designed for lung exercise, which could benefit both the general population and patients recovering from lung injuries.</p><p><strong>Objective: </strong>This research aimed to develop and evaluate a mobile app game for practicing lung exercises, accompanied by a prototype device called the Pulmo device.</p><p><strong>Methods: </strong>The study involved a sample group of 110 participants from the general public. It followed a research and development methodology comprising 4 steps. The research instruments included a mobile app game, a prototype lung exercise device, and questionnaires to assess users' satisfaction and the feasibility of both the app and the device.</p><p><strong>Results: </strong>The findings revealed that the participants demonstrated a high level of overall satisfaction with both the mobile app game and the prototype lung exercise device (mean 4.4, SD 0.4). The feasibility for the mobile app game and the prototype lung exercise device connected to the game was evaluated. The results indicated that the sample group perceived the overall feasibility to be at a high level (mean 4.4, SD 0.5).</p><p><strong>Conclusions: </strong>The research results reflected that the sample group believed the mobile app game for practicing lung exercises and the prototype device developed in this project have a high potential for practical application in promoting lung rehabilitation through gameplay. The mobile app game and the Pulmo device prototype received positive user feedback, indicating potential practical use; however, further validation is required among patients in need of pulmonary rehabilitation.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e63512"},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Speech and Language Therapists' Perspectives of Virtual Reality as a Clinical Tool for Autism: Cross-Sectional Survey.","authors":"Jodie Mills, Orla Duffy","doi":"10.2196/63235","DOIUrl":"10.2196/63235","url":null,"abstract":"<p><strong>Background: </strong>Persistent difficulties with social skills form part of the diagnostic criteria for autism and in the past have required speech and language therapy (SLT) management. However, many speech and language therapists are moving toward neuro-affirmative practices, meaning that social skills approaches are now becoming redundant. Research demonstrates that virtual reality (VR) interventions have shown promise in overcoming challenges and promoting skill generalization for autistic children; however, the majority of these focus on social skills interventions. While VR is emerging as an SLT intervention, its application for autism remains unexamined in clinical practice.</p><p><strong>Objective: </strong>This research aimed to examine speech and language therapists' knowledge and attitudes toward immersive VR as a clinical tool for autistic children and explore the reasons for its limited integration into clinical practice.</p><p><strong>Methods: </strong>A web-based cross-sectional survey was available from April 3, 2023 to June 30, 2023. The survey, consisting of 23 questions, focused on VR knowledge, attitudes, and the support required by speech and language therapists to incorporate VR into clinical practice. Dissemination occurred through the Royal College of Speech and Language Therapists Clinical Excellence Networks to recruit speech therapists specializing in autism.</p><p><strong>Results: </strong>Analysis included a total of 53 responses from the cross-sectional survey. Approximately 92% (n=49) of speech and language therapists were aware of VR but had not used it, and 1.82% (n=1) had used VR with autistic children. Three key themes that emerged were (1) mixed general knowledge of VR, which was poor in relation to applications for autism; (2) positive and negative attitudes toward VR, with uncertainty about autism specific considerations for VR; and (3) barriers to adoption were noted and speech and language therapists required an improved neuro-affirming evidence base, guidelines, and training to adopt VR into clinical practice.</p><p><strong>Conclusions: </strong>While some speech and language therapists perceive VR as a promising intervention tool for autistic children, various barriers must be addressed before its full integration into the clinical toolkit. This study establishes a foundation for future co-design, development, and implementation of VR applications as clinical tools for autistic children., This study is the first to explore clinical implementation factors for the use of VR in SLT field, specifically with autistic children. Poor autism-specific VR knowledge, and mixed attitudes toward VR, highlight that specific barriers must be addressed before the technology can successfully integrate into the SLT clinical toolkit., Speech and language therapists require support from employers, funding, a robust neuro-affirming evidence base, and education and training to adopt VR into practice. Recommendation","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e63235"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maxime Balloufaud, Arnaud Boujut, Romain Marie, Aurélie Guinaldo, Laurent Fourcade, Julia Hamonet-Torny, Anaick Perrochon
{"title":"Augmented Reality Exergames for Upcoming Cognitive-Motor Rehabilitation: User-Centered Design Approach and User Experience of Healthy Children.","authors":"Maxime Balloufaud, Arnaud Boujut, Romain Marie, Aurélie Guinaldo, Laurent Fourcade, Julia Hamonet-Torny, Anaick Perrochon","doi":"10.2196/69205","DOIUrl":"10.2196/69205","url":null,"abstract":"<p><strong>Background: </strong>Traditional rehabilitation programs for children with cerebral palsy and acquired brain injuries aim to enhance motor and cognitive abilities through repetitive exercises, which are often perceived as tedious and demotivating. Extended reality technologies, including augmented reality (AR) and virtual reality, offer more engaging methods through exergames. However, to date, no AR exergames simultaneously integrate cognitive and motor aspects within navigational tasks. Developing these exergames necessitates rigorous methodological steps, especially when using emerging technologies such as AR. The MIDE (Multidisciplinary Iterative Design of Exergames) framework advocates a participatory design approach, involving users from the outset, the objective being to optimize the interface and validate game mechanics through user experience (UX) assessment. Some researchers initially test these mechanisms on healthy children before applying them to clinical populations.</p><p><strong>Objective: </strong>This study aims to evaluate the UX of our AR exergames, consisting of two games (AR Corsi and AR Zoo), in typically developing children.</p><p><strong>Methods: </strong>Typically developing children participated in two 1.5-hour sessions. During each session, they played one of two AR games using the Microsoft HoloLens 2 headset: AR Corsi and AR Zoo, both of which are designed to engage executive functions and motor skills through navigational capabilities. UX was assessed after each session using the following measures: System Usability Scale scores for usability, AttrakDiff for attractiveness and game quality, MeCue for emotional experience, and Rating scale of Perceived Exertion for Children for pre- and postsession mental and physical fatigue.</p><p><strong>Results: </strong>A total of 27 participants (mean age 11.9, SD 1.2 years) were included in the study. Mean System Usability Scale scores were 79.9 (SD 11.4) for AR Corsi and 76.3 (SD 12.1) for AR Zoo, indicating good usability. The AttrakDiff questionnaire yielded favorable results, with scores between 1 and 3 for overall attractiveness, pragmatic quality, and stimulation for both AR games. However, the hedonic quality \"identity\" received neutral scores (mean 0.6, SD 0.5 for AR Corsi and mean 0.7, SD 0.8 for AR Zoo). The MeCue emotions module yielded average scores of 5.2 (SD 0.7) for AR Corsi and 5.3 (SD 0.8) for AR Zoo, significantly exceeding the theoretical mean of 4 (P<.001). We observed a significant effect of physical fatigue (P=.02) and mental fatigue (P=.002) after exposure to both games. A comparative analysis of UX between the two games showed no significant differences.</p><p><strong>Conclusions: </strong>This study demonstrates that our exergame, comprising two AR games, is user-friendly and well-received by typically developing children, eliciting positive emotions and overall appeal. Although some children reported fatigue, favorable UX evaluation confir","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e69205"},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Systematic Review of Advances in Infant Cry Paralinguistic Classification: Methods, Implementation, and Applications.","authors":"Geofrey Owino, Bernard Bernard Shibwabo","doi":"10.2196/69457","DOIUrl":"https://doi.org/10.2196/69457","url":null,"abstract":"<p><strong>Background: </strong>Effective communication is essential for human interaction, yet infants can only express their needs through various types of suggestive cries. Traditional approaches of interpreting infant cries are often subjective, inconsistent, and slow leaving gaps in timely, precise caregiving responses. A precise interpretation of infant cries can potentially provide valuable insights into the infant's health, needs, and well-being, enabling prompt medical or caregiving actions.</p><p><strong>Objective: </strong>This study seeks to systematically review the advancements in methods, coverage, deployment schemes, and applications of infant cry classification over the last 24 years. The review focuses on the different infant cry classification techniques, feature extraction methods, and the practical applications. Furthermore, we aimed to identify recent trends and directions in the field of infant cry signal processing to address both academic and practical needs.</p><p><strong>Methods: </strong>A systematic literature review was conducted by using nine electronic databases: Cochrane Database of Systematic Reviews, JSTOR, Web of Science Core Collection, Scopus, PubMed, ACM, MEDLINE, IEEE Xplore, and Google Scholar. A total of 5904 search results were initially retrieved, with 126 studies meeting the eligibility criteria after screening by two independent reviewers. The methodological quality of the studies was assessed using the Cochrane risk-of-bias tool version 2 (RoB2), with 92% (n=116) of the studies indicating a low risk of bias and 8% (n=10) of the studies showing some concerns regarding bias. The overall quality assessment was performed using the TRIPOD (Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis) guidelines. The data analysis was conducted using R version 3.64.</p><p><strong>Results: </strong>Notable advancements in infant cry classification methods were realized, particularly from 2019 onwards employing machine learning, deep learning, and hybrid approaches. Common audio features included Mel-frequency cepstral coefficients (MFCCs), spectrograms, pitch, duration, intensity, formants, zero-crossing rate and chroma. Deployment methods included mobile applications and web-based platforms for real-time analysis with 90% (n=113) of the remaining models remained undeployed to real world applications. Denoising techniques and federated learning were limitedly employed to enhance model robustness and ensure data confidentiality from 5% (n=6) of the studies. Some of the practical applications spanned healthcare monitoring, diagnostics, and caregiver support.</p><p><strong>Conclusions: </strong>The evolution of infant cry classification methods has progressed from traditional classical statistical methods to machine learning models but with minimal considerations of data privacy, confidentiality, and ultimate deployment to the practical use. Further research is thus proposed ","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mrudula Kanakapura Peramalaiah, Sanjay Tejraj Parmar, Nariman Sepehri, Saman Muthukumarana, Anuprita Kanitkar, Cherry Kit-Fong Hin, Tony Joseph Szturm
{"title":"Evaluation of a Game-Based Mechatronic Device for Rehabilitation of Hand-Arm Function in Children With Cerebral Palsy: Feasibility Randomized Controlled Trial.","authors":"Mrudula Kanakapura Peramalaiah, Sanjay Tejraj Parmar, Nariman Sepehri, Saman Muthukumarana, Anuprita Kanitkar, Cherry Kit-Fong Hin, Tony Joseph Szturm","doi":"10.2196/65358","DOIUrl":"10.2196/65358","url":null,"abstract":"<p><strong>Background: </strong>Children with neurodevelopmental disorders, such as cerebral palsy (CP), often experience motor impairments in manual dexterity, which hinder daily tasks and social interactions. Traditional rehabilitation methods require repetitive task practice, which can be difficult for children to sustain due to low engagement. Game-based rehabilitation devices and robots offer a promising alternative by combining therapy with digital play, improving motivation and compliance. However, many systems fail to incorporate actual object manipulation, which is essential for motor learning through sensory feedback. To address this limitation, a low-cost, easy-to-use robotic manipulandum device (RMD) was developed. The RMD enables real-time object manipulation during gameplay while providing assistive force, allowing the practice of a wide range of manual dexterity skills beyond gross reaching. This system offers an engaging and effective rehabilitation approach to enhance hand function in children with CP.</p><p><strong>Objective: </strong>This study aimed to provide evidence for the feasibility and therapeutic value of the RMD game-based exercise program for children with CP.</p><p><strong>Methods: </strong>In total, 34 children with CP, aged 4 to 10 years, were randomly assigned to the experimental group (XG) or the control group (CG). The XG received a computer game-based exercise program using the RMD, focusing on object manipulation tasks, while the CG received task-specific training similar to constraint-induced movement therapy. Both groups received their respective therapy programs 3 times per week for 8 weeks. Semistructured interviews with parents and children, along with qualitative analysis, were conducted to evaluate their experiences with the exercise program. The following outcome measures were used: (1) the Peabody Developmental Motor Scale-2 (PDMS-2) grasping and visual-motor integration subtests and (2) the computer game-based upper extremity (CUE) assessment of manual dexterity.</p><p><strong>Results: </strong>No dropouts occurred during the 8-week program. Both groups showed significant improvements in the PDMS-2 subtests (P<.001) and the CUE assessment of manual dexterity, including success rates (tennis ball: P=.001; cone: P<.001; medicine ball: P=.001; and peanut ball: P<.001) and movement errors (tennis ball: P=.01; cone: P<.001; medicine ball: P=.04; and peanut ball: P<.001). The XG outperformed the CG, showing greater improvements in PDMS-2 grasping (P=.002) and visual-motor integration (P=.01). In the CUE assessment, the XG demonstrated higher success rates (medicine ball: P=.001 and peanut ball: P=.02) and fewer movement errors (cone: P<.001). Parents reported an increase in the children's independence in daily tasks.</p><p><strong>Conclusions: </strong>This study demonstrates the feasibility, acceptability, and positive outcomes of the RMD game-based exercise program for improving hand function in childre","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e65358"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}